Zestoretic is used in the treatment of high blood pressure. It combines an ACE inhibitor drug with a diuretic. Lisinopril, the ACE inhibitor, works by limiting production of a substance that promotes salt and water retention in your body. Hydrochlorothiazide, a diuretic, prompts your body to produce and eliminate more urine, which helps in lowering blood pressure. Combination products such as Zestoretic are usually not prescribed until therapy is already under way.

Most important fact about Lisinopril, Hydrochlorothiazide

You must take Zestoretic regularly for it to be effective. Since blood pressure declines gradually, it may be several weeks before you get the full benefit of Zestoretic; and you must continue taking it even if you are feeling well. Zestoretic does not cure high blood pressure; it merely keeps it under control.

How should you take Lisinopril, Hydrochlorothiazide ?

Zestoretic can be taken with or without food once a day. Take it exactly as prescribed.

–If you miss a dose…

Take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take a double dose.

–Storage instructions…

Zestoretic should be stored at room temperature. Keep the container tightly closed.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Zestoretic.

• More common side effects may include:
  Cough, dizziness, dizziness when standing up, fatigue, headache

Possible food and drug interactions when taking Lisinopril, Hydrochlorothiazide

Zestoretic may intensify the effects of alcohol. Do not drink alcohol while taking Lisinopril, Hydrochlorothiazide .

If Zestoretic is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Zestoretic with the following:

Barbiturates such as Nembutal and Seconal
Cholestyramine (Questran)
Colestipol (Colestid)
Corticosteroids such as prednisone
High blood pressure drugs such as Procardia XL and Aldomet
Indomethacin (Indocin)
Insulin
Lithium (Lithonate)
Narcotics such as Darvon and Dilaudid
Nonsteroidal anti-inflammatory drugs such as Naprosyn
Oral antidiabetic drugs such as Micronase
Potassium supplements such as K-Dur and Slow-K
Potassium-containing salt substitutes
Potassium-sparing diuretics such as Midamor

Special information if you are pregnant or breastfeeding

During the second and third trimesters, lisinopril can cause birth defects, prematurity, and death in the fetus and newborn. If you are pregnant or plan to become pregnant, contact your doctor immediately to discuss the potential hazard to your unborn child. Zestoretic may appear in breast milk and could affect a nursing infant. If Lisinopril, Hydrochlorothiazide is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Lisinopril, Hydrochlorothiazide is finished.

Recommended dosage

ADULTS

Zestoretic is designed to replace higher doses of either component. Dosages of the lisinopril component range from 10 to 80 milligrams a day; dosages of hydrochlorothiazide typically fall between 6.25 and 50 milligrams daily. If either component, when prescribed alone, fails to control your blood pressure, your doctor may try the Zestoretic combination, starting with either 10 or 20 milligrams of lisinopril and 12.5 milligrams of hydrochlorothiazide, and gradually increasing the dosage as needed.

If you are age 65 or older, or have kidney problems, your doctor will adjust your dosage with caution. This drug is not prescribed for people with severe kidney damage.

CHILDREN

Safety and effectiveness in children have not been established.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical treatment immediately.

• Symptoms of Zestoretic overdose may include:
  Dehydration, low blood pressure

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Furosemide is a loop diuretic (water pill) that prevents your body from absorbing too much salt, allowing the salt to instead be passed in your urine.

Furosemide treats fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. This medication is also used to treat high blood pressure (hypertension).

Furosemide may also be used for purposes other than those listed in this medication guide.

How should I take Furosemide?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Furosemide will make you urinate more often and you may get dehydrated easily. Follow your doctor’s instructions about using potassium supplements or getting enough salt and potassium in your diet.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your kidney or liver function may also need to be tested. It is important that you not miss any scheduled visits to your doctor.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

Store this medication at room temperature away from heat, light, and moisture.

What are the possible side effects of Furosemide?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using furosemide and call your doctor at once if you have any of these serious side effects:

• dry mouth, thirst, nausea, vomiting
• feeling weak, drowsy, restless, or light-headed
• fast or uneven heartbeat
• muscle pain or weakness
• urinating less than usual or not at all
• easy bruising or bleeding, unusual weakness
• a red, blistering, peeling skin rash
• hearing loss; or
• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)

Continue taking furosemide and talk with your doctor if you have any of these less serious side effects:

• diarrhea, constipation, or stomach pain
• headache
• numbness, burning, pain, or tingly feeling
• dizziness; or
• blurred vision

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs affect Furosemide?

If you take sucralfate (Carafate), take it at least 2 hours before or after you take furosemide.

Before taking this medication, tell your doctor if you are using any of the following drugs:

• lithium
• digoxin (Lanoxin)
• steroids (prednisone and others)
• ethacrynic acid (Edecrin)
• diet pills or cold medicine
• other blood pressure medications
• amikacin (Amikin), gentamicin (Garamycin), netilmicin (Netromycin), streptomycin, tobramycin (Nebcin, Tobi)
• salicylates such as aspirin, Disalcid, Doan’s Pills, Dolobid, Salflex, Tricosal, and others; or
• indomethacin

If you are using any of these drugs, you may not be able to use furosemide, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect furosemide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What should I avoid while taking Furosemide?

Avoid becoming dehydrated. Follow your doctor’s instructions about the type and amount of liquids you should drink while you are taking furosemide.

Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Furosemide can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

What happens if I overdose on Furosemide?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a furosemide overdose may include ringing in your ears, loss of appetite, weakness, dizziness, confusion, feeling light-headed, or fainting.

What happens if I miss a dose of Furosemide?

Furosemide is sometimes used only once, so you may not be on a dosing schedule. If you are using the medication regularly, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not take extra medicine to make up the missed dose.

What is the most important information I should know about Furosemide?

Do not use this medication if you are unable to urinate.

Before using this medication, tell your doctor if you have kidney disease, liver disease, gout, lupus, diabetes, or an allergy to sulfa drugs.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your kidney or liver function may also need to be tested. It is important that you not miss any scheduled visits to your doctor.

Furosemide will make you urinate more often and you may get dehydrated easily. Follow your doctor’s instructions about using potassium supplements or getting enough salt and potassium in your diet.

Avoid becoming dehydrated. Follow your doctor’s instructions about the type and amount of liquids you should drink while you are taking furosemide.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

What should I discuss with my healthcare provider before taking Furosemide?

Do not use this medication if you are unable to urinate.

Before using furosemide, tell your doctor if you have:

• kidney disease
• liver disease
• gout
• lupus
• diabetes; or
• an allergy to sulfa drugs

If you have any of these conditions, you may not be able to use furosemide, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Furosemide can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

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